Introduction

In contrast to earlier times, a modern lifestyle requires a healthy lifestyle. Inactivity leads to the body being under-challenged, and consequently, entire body systems degenerate (Brehm et al., 2006). Indeed, approximately one-half of women and one-third of men are impairing their health through insufficient physical activity (Varney et al., 2014). However, different studies underline the positive impact of sports on common diseases. On the physical side, a physically active lifestyle offers low rates of all causes of mortality (Nocon et al., 2008), the prevention of non-communicable diseases (Lee et al., 2012), the ability to maintain functional independence in later life (Hall & McAuley, 2011; Keysor, 2003) and a lower risk of stroke (J. Berlin & Colditz, 1990). Additionally, regular sports activity is the best medicine to slow the progression of Alzheimer’s disease and leads to a significantly lower risk of Alzheimer’s disease (Churchill et al., 2002; Cotman & Berchtold, 2002).

Traditionally, golf has never been perceived as a sport leading to physical fitness. Instead, golf has characteristically been considered a low-impact sport, and most candidates are seemingly unaware of the potential health benefits (McHardy et al., 2006). However, Driver (1996) elaborates that the personal health benefits of participating in golf are physiological health and preservation, increased self-confidence and enriched cognitive performance. In this context, golf, as a recreational sport, requires the player to undergo a variety of physically demanding movements throughout the duration of play (Hume et al., 2005). Additionally, golf is related to a number of psychological gains, including decreased anxiety and depression and increased feelings of well-being and social interaction (K. L. Berlin & Klenosky, 2014; Folkins & Sime, 1981). Additionally, the death rate for golfers is 40% lower than that for other individuals of the same sex, age and socioeconomic status, which corresponds to a 5-year increase in life expectancy (Farahmand et al., 2009). In total, golf can provide moderate-intensity physical activity and is associated with longevity, physical health and wellness benefits (Murray et al., 2018). In this context, Murray et al. (2018) describe that the magnitude of golf-related health benefits depends on factors such as age, gender, genetic factors, the fitness level of the participant, the topography of the golf course and the frequency of play. However, playing golf evokes moderate golf-specific injuries (Cabri et al., 2009), and in sunny regions, it increases the risk of skin cancer (Hanke et al., 1985).

Despite the mostly positive effects of golf on health, golf as a health sport is only slowly starting to be implemented in international golf governance and management (Breitbarth & Huth, 2019). However, this change could be important, especially in the stagnating golf market, as health sports are growing. Instead, different golf institutions are primarily focused on attracting more youth and women and adopting rules designed to make the game much easier and faster (Fischer & Kaiser-Jovy, 2018). However, initial initiatives from various stakeholders, such as golf associations, health insurance companies and golf clubs, have become apparent in the context of golf as a health sport. The German Golf Association focuses on collecting different medical studies and plans to establish a health-oriented programme by 2020 (Breitbarth & Huth, 2019).

In this paper, we aim to evaluate the extent to which golf clubs, as a central golf provider, assess the subject of golf as a health sport. In particular, we aim to analyse three different areas. In detail, from a club’s point of view, we aim to show (a) the forecasted potential of golf as a health sport, (b) which stakeholders – on the supply and demand side – are seen as important and central in the implementation, and (c) which health actions are seen as most promising. In addition, we analyse the differences between golf clubs that are already carrying out health campaigns and actions and clubs that are not yet focused on health. From the results, fields of action and initial proposals for concrete health measures in golf sports are to be derived and pointed out. In this context, future research fields and questions will be outlined from a scientific perspective. Therefore, this study provides management insights into a relatively new area for golf in the context of health. After the method is described, the results of our analysis are presented and discussed, followed by the conclusion.

Methods

The study follows a direct, primary empirical research design that focuses on German golf clubs. We chose the German golf market for three reasons. First, it is the largest golf market in (Central) Europe that is not influenced by specific market characteristics, such as traditional attributes (Great Britain and Ireland) or tourism-related attributes (Southern European markets such as Spain, Portugal or Turkey) (Huth & Kurscheidt, 2018; IAGTO, 2013). Second, after years of growth, the German golf market has stagnated for over 5 years, so a new impetus is needed to attract new golfers. Finally, the German Golf Association, the golf-governing body in Germany, is in the process of launching the Golf & Health programme (DGV – Deutscher Golf Verband, 2017b). Currently, as mentioned above, the project is in its initial phase and is far from being implemented in practice.

A standardized online questionnaire was designed for the primary empirical investigation, and for time and cost reasons, it was placed online via the Qualtrics survey tool (Li et al., 2008; Wright, 2006). The questionnaire can be roughly divided into five parts:

  1. General questions about golf as a health sport and an evaluation of the relevance and motivation for golf as a health sport

  2. Evaluation of the central players for positioning

  3. Evaluation of the potential target groups

  4. Evaluation of actions in the context of golf as a health sport

  5. Club-related data

The first part of the survey asks whether golfing has a positive impact on health and whether it is more of a rehabilitative or preventative sport. In this context, the golf clubs are asked if they have already offered health services themselves. Additionally, the first part of the survey analyses the role of golf as a health sport generally and, especially, in golf clubs today and in the future. Finally, in line with the first research aim of the study – the potential of golf as a health sport –, the introduction asks whether golf should be positioned as a health sport and where the benefits of doing so could lie. In line with the second research aim, the golf clubs are asked in the second part to evaluate which stakeholders are particularly important with regard to the subject of golf as a health sport. Next, the clubs are asked to evaluate the attractiveness of potential target groups. Fourth, in line with the third research aim, the clubs are asked to evaluate some measures or actions in the context of golf as a health sport. Finally, the golf clubs are asked to answer specific questions about their club (legal form, professional club manager, number of members, holder of the Golf & Nature certificate).

Regarding the evaluation of the selected items, the participating golf clubs mostly answered questions on a 5-point Likert scale (e.g., from 1 = unimportant to 5 = important). Such scales have been widely used as they best reflect the preferences of participants (Revilla et al., 2014).

In the data analysis, we deliver descriptive data as well as bivariate results. Because of the different horizons of experience between golf clubs that have already carried out health actions and those who have not, the mean values of “health” and “non-health” golf clubs were compared. Therefore, in addition to the general descriptive results, the results of the mean value comparison and the mean values of both considered groups are listed in each table.

As mentioned before, representatives of German golf clubs are surveyed. The German golf market contains a total of 732 golf clubs (DGV – Deutscher Golf Verband, 2017b). All golf courses in Germany for which the author obtained a functioning electronic address were contacted by e-mail (n=600) with a request to forward the message either to the manager or to a responsible person. The clubs were asked to select the person best versed in this subject. At the club level, only golf clubs with a golf course with at least nine holes were contacted. This criterion excluded golf facilities with, for example, only exercise facilities such as a driving range or a short course. Approximately two weeks after the first e-mail, the clubs were sent a reminder about the survey. The questionnaire was available for one month from March to April 2019.

The recipients clicked on the online questionnaire 142 times, and ultimately, participants from 122 golf courses completed it (for a participation rate of 20% of the contacted clubs). Of all of the participating golf clubs in our study, 41% already offer information sessions, health days or courses focused on the health aspects of golf (in absolute numbers this means: 50 health clubs and 72 non-health clubs). Of the participating golf courses, nearly two-thirds had the legal form “e.V”. (registered association) and employed a club manager. On average, participating courses had approximately 700 members. Furthermore, 30% of the participating golf clubs had Golf & Nature certificates. Nearly 22% of all German golf clubs are certified with this environmental certificate (DGV – Deutscher Golf Verband, 2017b); thus, certified golf clubs are very well represented.

Results and Discussion

The main results of the study are presented below. The sequence roughly follows the course of the survey described in the previous section as well as the stated research aims.

Table 1 shows that most golf clubs agree that golf has a positive effect on health. The results are thus in line with the scientific studies already mentioned, which also confirm a positive effect on the sport of golf.

Table 1: Golf as a health sport assessment and relevance
Mean Standard
deviation
Min Max Sign of
differences
by clubs
Mean
non-health clubs
Mean
health clubs
Golf has a positive health effect 4.77 0.65 1 5 0.00 4.64 4.96
Golf as rehabilitation or prevention sport 2.44 0.51 1 3 0.72 2.45 2.41
Current relevance “golf as health sport” in Germany 3.09 1.11 1 5 0.90 3.07 3.12
Future relevance “golf as health sport” in Germany 2.76 0.45 1 3 0.69 2.74 2.78
Current relevance “golf as health sport” in the club 2.99 0.94 1 5 0.03 2.81 3.25
Future relevance “golf as health sport” in the club 2.75 0.43 2 3 0.56 2.73 2.78
Positioning golf as health sport 4.40 0.65 2 5 0.17 4.33 4.51
Positive impulse of golf as health sport 4.23 0.84 1 5 0.12 4.13 4.37
Positive impulse on memberships 3.87 0.93 1 5 0.27 3.79 3.98

It is noticeable that the golf clubs that have already carried out health actions agree with this statement to a significantly higher degree than the “non-health” golf clubs. In line with previously mentioned studies, a majority of the golf clubs say that golf is more suitable as a prevention sport than a rehabilitation sport. With mean values around 3 on a 5-point Likert scale, it can be stated that golf has a moderate status as a health sport in both German golf and most golf clubs. Nevertheless, the golf clubs attest that the relevance of the sport as a health sport will clearly increase both in Germany and in the clubs in the next few years. Overall, there is also a high level of agreement that golf should be positioned more strongly as a health sport in the future. Most golf clubs generally expect positive momentum for the sport of golf and – slightly weaker – for golf club memberships. Based on the initial results, the first research aim is addressed as follows: it can be seen that golf is perceived as a health sport by the clubs, even though its place among health sports is currently considered to be minor. From a marketing point of view, promoting golf primarily as a prevention sport seems to be particularly lucrative.

Next, in line with the second research aim, the results of the assessment of the potential stakeholders are presented. As Table 2 shows, clubs rated with values above “4”, health insurance companies, golf associations, the media, medical institutions and the golf clubs themselves, as the most important stakeholders for positioning golf as a health sport. University facilities are just behind in the ratings. In contrast, professional tour series and political institutions are assessed as rather insignificant. It is noteworthy that the “health” golf clubs rate the role of golf clubs as significantly more important than the group of “non-health” clubs.

Table 2: Evaluation of central stakeholders
Mean Standard
deviation
Min Max Sign of
differences
by clubs
Mean
non-health clubs
Mean
health clubs
Statutory health insurance 4.09 0.99 1 5 0.14 3.97 4.25
Private health insurance 4.34 0.76 1 5 0.51 4.28 4.43
Golf clubs 4.34 0.83 1 5 0.02 4.20 4.55
Professional tour 2.72 1.23 1 5 0.80 2.73 2.71
National golf associations 4.15 0.99 1 5 0.40 4.20 4.08
Sport associations 3.83 1.15 1 5 0.97 3.81 3.84
Political institutions 3.51 1.26 1 5 0.93 3.53 3.47
Media 4.38 0.85 1 5 0.21 4.33 4.45
Medical institutions 4.40 0.80 1 5 0.17 4.33 4.51
School 3.87 1.21 1 5 0.59 3.87 3.88
Universities 3.95 1.16 1 5 0.71 3.95 3.96
Sportswear manufacturer 3.74 1.24 1 5 0.61 3.70 3.78

Overall, it can be seen that positioning golf as a health sport is a complex act involving several stakeholders. Of course, individual golf clubs can implement initial local actions, which have to be implemented and practiced daily by the golf clubs themselves. However, this approach needs to be accompanied by the actions of other stakeholders, such as golf associations and the media, through further marketing measures and intermediary actions that positively influence and change the image of golf.

Also in line with the second research aim, table 3 offers the results of the evaluation of the potential target groups. Given the current age structure in golf, the golf clubs evaluate the target group of seniors as the most attractive in the context of golf as a health sport. Younger people are much less relevant from the perspective of golf clubs. There is no a significant difference between the two groups of golf clubs with regard to any of the target groups.

Table 3: Evaluation of potential target groups
Mean Standard
deviation
Min Max Sign of
differences
by clubs
Mean
non-health clubs
Mean
health clubs
Kids 2.37 1.31 1 5 0.64 2.29 2.47
Students 2.58 1.12 1 5 0.65 2.53 2.65
Families 3.51 1.03 1 5 0.84 3.52 3.49
Professionals 3.98 0.95 1 5 0.47 3.99 3.98
Seniors 4.70 0.64 1 5 0.24 4.67 4.75

However, as mentioned above, a modern lifestyle also requires a healthy lifestyle in today’s society. Therefore, it is advisable that golf clubs win younger people to the sport in addition to their traditional (older) target group. Especially as a balance for physically (conditionally) demanding sports, golf can also be an attractive alternative for younger people.

Finally, in line with the last research aim, the results of the evaluation of the selected actions in the context of golf as a health sport are shown. Overall, with values above “3”, all the listed actions are meet with approval. However, from the point of view of the golf clubs, cooperation with health insurance companies and other corporations as well as special seminars on health topics are the most expedient. It is noticeable in this context that, in five out of seven measures, the “health” golf clubs find the activities significantly more interesting than the “non-health” golf clubs. This could be due to the experience already acquired by the “health” golf clubs, which could have previously implemented some of these measures successfully.

Table 4: Evaluation of central stakeholders
Mean Standard
deviation
Min Max Sign of
differences
by clubs
Mean
non-health clubs
Mean
health clubs
Health day for club members 3.60 1.09 1 5 0.30 3.53 3.71
Public open day on "golf as a health sport" 3.78 1.11 1 5 0.11 3.65 3.96
Regional marketing measures 3.61 1.14 1 5 0.05 3.45 3.84
Health cooperation with health insurance 4.31 0.88 1 5 0.04 4.15 4.55
Health cooperation with companies 4.20 0.86 1 5 0.02 4.05 4.41
Offering seminars on specific topics 4.08 0.92 1 5 0.00 3.89 4.35
Regular health information for members 3.64 1.13 1 5 0.00 3.39 4.02

In the area of occupational health sports in particular, cooperation between golf clubs and companies could be worthwhile as the golf clubs rated cooperation with companies as second most interesting and important possible measure. As a result, golf clubs have the opportunity to make contact with people interested in playing golf and possibly win them permanently as members.

Conclusion

Traditionally, most direct or indirect golf-related stakeholders have been seemingly unaware of the potential health benefits of golf. Thanks to a number of studies (Driver, 1996; Grov & Dahl, 2019; Luscombe et al., 2017; Stenner et al., 2019), most of which have highlighted the great benefits of golf to health, the picture has recently changed. However, apart from the first smaller measures (e.g., the mentioned initiative of the German Golf Association or the initiative Golf & Health), there is still little evidence of golf being positioned as a health sport. For the first time, this paper aimed to evaluate the extent to which golf clubs, as central golf providers, assess the subject of golf as a health sport.

The results clearly show that the golf clubs, on the one hand, regard golf as a health sport, but on the other hand, this recognition has not been accompanied by any actions. However, the clubs are clearly in favour of future positioning as a health sport. In the implementation process, it is recommended that the golf clubs do not try to achieve this goal alone but also involve other stakeholders. In addition to health insurance companies and medical facilities, which are classically part of the health context, national and international golf associations should also be involved. A first initiative, which is still in its infancy, was initiated by the German Golf Association with the campaign “Golf & Health” (DGV – Deutscher Golf Verband, 2017b). A role model here is the successful initiative “Golf & Nature” (Huth, 2017a, 2017b), which was launched some time ago. Together with the golf clubs and other stakeholders, such as the media, it is important to further promote and expand such health initiatives in golf. Following the general health trend, classic thinking patterns should be broken in gaining new golfers, and younger target groups such as families should be more involved. An open day or cooperation with health insurance companies, other companies or educational institutions are attractive opportunities to promote the sport of golf to the general public and make it known as a health sport.

A limitation of our study is that the response rate of the questionnaire was relatively low at 20% and that 40% of the respondents held health sessions. Thus, the clubs that replied are already interested in health and may not be representative. However, in order to be independent, we have made the study completely independent of the German Golf Association. Additionally, as the results of the study show, knowledge of this topic is still far from up-to-date in German golf. For the very first study, which polls primary golf clubs on the subject, the participation rate is quite satisfactory.

Future research should also put golfers and non-golfers at the centre of activities in the context of golf as a health sport. This study provides a good impression of the supply side. The demand side should now be examined accordingly to determine to what extent the assessments are the same or different. With this knowledge, the supply side can then design and implement more targeted measures in the context of golf as a health sport.